摘要
目的 观察曲唑酮联合氟伏沙明治疗抑郁症伴发失眠的疗效及对多导睡眠图、血清肽类神经递质、白细胞介素(IL)-1β水平的影响。方法 选取本院抑郁症伴发失眠症状患者360例,根据治疗方法不同均分为对照组(马来酸氟伏沙明治疗)和观察组(盐酸曲唑酮联合马来酸氟伏沙明治疗)。比较两组治疗前后汉密尔顿抑郁量表17项(HAMD-17)、匹兹堡睡眠质量指数(PSQI)、健康调查量表36项(SF-36)评分以及多导睡眠图参数、血清神经肽Y(NPY)、P物质(SP)、IL-1β水平。比较两组临床疗效及不良反应发生情况。结果 与治疗前比较,治疗后两组HAMD-17、PSQI总分、SP、IL-1β水平降低(P<0.05),SF-36总分、NPY水平升高(P<0.05);总睡眠时间、快速眼动-睡眠时间、慢波睡眠时间延长(P<0.05),觉醒次数减少(P<0.05),睡眠效率提高(P<0.05),睡眠潜伏期、觉醒时间缩短(P<0.05),且以观察组改善更显著(P<0.05)。观察组总有效率高于对照组(P<0.05)。两组不良反应发生率差异无显著性(P>0.05)。结论 曲唑酮联合氟伏沙明对抑郁症伴发失眠症状患者的抑郁症状、睡眠进程及结构均有明显改善效果,可有效提高总体疗效,并能良性调节血清相关肽类神经递质及IL-1β水平,且患者耐受性较好。
Aim To observe the clinical efficacy of trazodone combined with fluvoxamine on the treatment of depression with insomnia and the effects on polysomnogram,serum peptide neurotransmitter,interleukin(IL)-1β levels.Methods 360 patients with depression accompanied by insomnia were selected and divided into control group(fluvoxamine maleate treatment) and observation group(trazodone hydrochloride combined with fluvoxamine maleate treatment) according to different treatment methods.17 items of Hamilton depression scale(HAMD-17),Pittsburgh sleep quality index(PSQI),36-item short form health survey(SF-36) scores,polysomnography parameters,serum neuropeptide Y(NPY),substance P(SP) and IL-1β levels were compared between the two groups before and after treatment.The clinical efficacy and adverse reactions were compared between the two groups.Results Compared with parameters before treatment,the total score of HAMD-17,PSQI,SP,IL-1β levels were decreased after treatment(P<0.05),while the total score of SF-36 and serum NPY levels were increased(P<0.05).Total sleep time,rapid eye movement-sleep time and slow-wave sleep time were significantly extended(P<0.05),wake times was decreased(P<0.05),sleep efficiency was increased(P<0.05),and sleep latency and wake time were shortened(P<0.05).The improvement was more significant in the observation group(P<0.05).The total effective rate of observation group was higher than that of control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Trazodone combined with fluvoxamine can significantly improve the depressive symptoms,sleep process and structure of patients with depression and insomnia symptoms,effectively improve the overall treatment effect,and can regulate the levels of serum related peptide neurotransmitters and IL-1β in a benign manner,with good patient tolerance.
作者
张晓娟
刘松涛
韩荦杰
贺英
许珊珊
刘海港
张莉
张顺
ZHANG Xiaojuan;LIU Songtao;HAN Luojie;HE Ying;XU Shanshan;LIU Haigang;ZHANG Li;ZHANG Shun(Sleep Ward,Kailuan Mental Health Center of Kailuan Medical and Health Industry Group,Tangshan 063000,Hebei,China)
出处
《中南医学科学杂志》
CAS
2024年第5期760-763,818,共5页
Medical Science Journal of Central South China
基金
河北省医学科学研究重点课题计划(20210818)。
